Conn's syndrome

Question 1

What is conn’s syndrome?

Answer 1

Primary hyperaldosteronism

Xs production of aldosterone by adrenal adenoma

Question 2

What is the pathophysiology?

Answer 2

Xs aldosterone acts on distal renal tubule = Na retention and K excretion = HTN and hypokalaemia

Question 3

What are the Sx?

Answer 3

HTN
Muscle weakness - hypoK
Polyuria 
Polydipsia 
Metabolic alkalosis

Question 4

What Ix and what do you see?

Answer 4

Initial screening: Renin/aldosterone ratio (low renin, aldosterone high)
0.9% saline infusion - aldosterone not suppressed
U&E - hyperNa, hypoK
ECG - hypoK signs

Question 5

When is primary aldosterone excluded?

Answer 5

When renin is not low

Question 6

What are the signs of hypoK on ECG?

Answer 6

U have no Pot and no T, but a long PR and a long QT

Prominent U waves
Flat P waves
Small/flat T waves
Long PR interval 
Long QT interval

Question 7

How is it mx?

Answer 7

Laparoscopic adrenelectomy
- to remove adrenal adenoma

In meantime, give oral spirinolactone

Question 8

What is spirinolactone?

Answer 8

Aldosterone antagonist

Potassium sparing

aka K sparing diuretic